Molecular Biology RMT2026 Past Paper PDF

MOLECULAR BIOLOGY RMT2026 INSTRUCTOR: NIÑA REEZA GUILLERMO-ESQUILLO, RMT, MLS (ASCPi) I. HEALTH, SAFETY AND SECURITY 2. Specifically mandated plans (e.g., chemical...

MOLECULAR BIOLOGY RMT2026 INSTRUCTOR: NIÑA REEZA GUILLERMO-ESQUILLO, RMT, MLS (ASCPi) I. HEALTH, SAFETY AND SECURITY 2. Specifically mandated plans (e.g., chemical hygiene, bloodborne A. Health pathogens) A general state of physical, mental and 3. Identification of various hazards (e.g., emotional well-being. chemical, biological) B. Safety IV.SAFETY AGENCIES AND Condition in which the physical well-being of ORGANIZATIONS people is protected. 1. U.S. Department of Labor’s Occupational Safety and Health C. Security Administration (OSHA) Protection of employees and organizational facilities. 2. Clinical and Laboratory Standards Institute (CLSI) II.SAFETY IN THE LABORATORY Safety standards for patients and 3. CDC, part of the U.S. Department of clinical laboratories are initiated, Health and Human Services (DHHS), governed, and reviewed by Public Health Service government agencies and professional organizations. 4. College of American Pathologists The Joint Commission has (CAP) established National Patient Safety Goals. 5. The Joint Commission (The Joint One of the goals of particular interest Commission on Accreditation of to laboratory professionals addresses Healthcare Organizations) the issue of critical laboratory assay values, the high and low boundaries The Safety Officer of the life-threatening values of A designated safety officer is a critical laboratory test results. part of a laboratory safety program. Urgent clinician notification of critical This individual has any duties results is the responsibility of the affecting staff including compliance laboratory. with existing regulations affecting the laboratory and staff. III.OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION ACTS AND V.SAFE WORK PRACTICES AND STANDARD PROTECTIVE TECHNIQUES FOR (OSHA) and the Centers for Disease INFECTION CONTROL Control and Prevention (CDC) have published numerous safety standards Safety Manual, Policies and Practices and regulations that are applicable to Each laboratory must have an up-to- clinical laboratories. date safety manual. This manual contains a comprehensive listing of Ensuring safety in the clinical laboratory approved policies, acceptable includes the following measures practices, and precautions including 1. A formal safety program standard precautions. PRELIMS | 1ST SEMESTER A.Y. 2024 - 2025 Page 1 of 9 farahway˙✧˖°🪸 ༘ ⋆｡˚ MOLECULAR BIOLOGY RMT2026 INSTRUCTOR: NIÑA REEZA GUILLERMO-ESQUILLO, RMT, MLS (ASCPi) Because many hazards in the clinical VII.GUIDELINES FOR HANDWASHING laboratory are unique, a special term, AND HAND ANTISEPSIS IN biohazard, was devised. This word is HEALTHCARE SETTINGS posted throughout the laboratory to denote infectious materials or agents 1. Wash hands with a nonantimicrobial that present a risk or even a potential soap and water or an antimicrobial risk to the health of humans or soap and water when hands are animals in the laboratory. visibly dirty or contaminated with proteinaceous material. Laboratory policies are included in a laboratory reference manual that is 2. Use an alcohol-based waterless available to all hospital personnel. antiseptic agent for routine Approved policies regarding the decontamination of hands, if not reporting of abnormal values are visibly soiled. clearly stated in this document. 3. Waterless antiseptic agents are The potential risk can be either highly preferable, but hand antisepsis through direct infection or through the using antimicrobial soap may be environment. Infection can occur considered in certain circumstances. during the process of specimen collection or from handling, 4. Decontaminate hands after contact transporting, or testing the specimen. with the patient’s skin. VI.PERSONAL SAFETY 5. Decontaminate hands after contact with blood and body fluids. Standard Precautions Standard precautions are intended to 6. Decontaminate hands if moving from prevent occupational exposures to a contaminated area to clean body bloodborne pathogens. site during patient care. According to the CDC concept of standard precautions, all human 7. Decontaminate hands after contact blood and other body fluids are with inanimate objects in the treated as potentially infectious for immediate vicinity of a patient. HIV, HBV, and other bloodborne microorganisms that can cause 8. Decontaminate hands after removing disease in humans. gloves. Handwashing Modified from Centers for Disease Frequent handwashing is an Control and Prevention, U.S. Department important safety precaution. It must of Health and Human Services. be performed after contact with Guideline for Hand Hygiene in patients and laboratory specimens. Healthcare Settings, Morb Mortal Wkly Gloves should be used as an adjunct Rep, 51(RR-16):1, 2002. to, not a substitute for, handwashing. PRELIMS | 1ST SEMESTER A.Y. 2024 - 2025 Page 2 of 9 farahway˙✧˖°🪸 ༘ ⋆｡˚ MOLECULAR BIOLOGY RMT2026 INSTRUCTOR: NIÑA REEZA GUILLERMO-ESQUILLO, RMT, MLS (ASCPi) VIII. Two important points in the practice A laboratory coat should be used of hand hygiene technique are: whenever laboratory personnel are When decontaminating hands with a working with potentially infectious waterless antiseptic agent (e.g., an specimens. alcohol-based handrub), apply The coat worn in the laboratory must product to the palm of one hand and be changed or covered with an rub hands together, covering all uncontaminated coat when leaving surfaces of hands and fingers, until the immediate work area. hands are dry. If an adequate volume of an alcohol 3. Foot protection based handrub is used, it should take designed to prevent injury from 15 to 25 seconds for hands to dry. corrosive chemicals or heavy objects. When washing with a non- If a corrosive chemical or heavy antimicrobial or antimicrobial soap, object were to fall on the floor, the wet hands first with warm water, apply most vulnerable portion of the body 3 to 5 mL of detergent to hands, and would be the feet. rub hands together vigorously for at For this reason, shoes that least 15 seconds, covering all completely cover and protect the foot surfaces of the hands and fingers. are worn in the laboratory. Rinse hands with warm water and dry thoroughly with a disposable towel. 4.Hand protection Use the towel to turn off the faucet. Heat-resistant gloves for handling hot or cold objects (e.g., dry ice) and latex The Department of Health and Human or nitrile gloves to prevent exposure Services (CDC) issued a draft guide in 2001 to biological hazards must be for Hand Hygiene in Healthcare Settings available. Selection of protective gloves is IX. PERSONAL PROTECTIVE based on chemical hazard and the EQUIPMENT tasks involved. OSHA requires that employers provide all necessary personal protective equipment X.SAFETY EQUIPMENT (PPE) to employees. 1.Individual storage containers 1. Eye protection Goggles and face shield a. Selecting the best means of storage for chemical reagents will, to a great extent, 2. Protective clothing depend on that reagent’s compatibility with The laboratory coat is designed to the container. A safety can is an approved protect the clothing and skin from container of no more than 5-gallon chemicals that may be spilled or capacity. It has a spring-closing lid and splashed. spout cover and is designed to safely relieve It should be worn buttoned up and pressure buildup within the container. with the sleeves extended to the wearer's wrist. b. Sharps containers: Hard containers for the disposal of sharp objects such as used PRELIMS | 1ST SEMESTER A.Y. 2024 - 2025 Page 3 of 9 farahway˙✧˖°🪸 ༘ ⋆｡˚ MOLECULAR BIOLOGY RMT2026 INSTRUCTOR: NIÑA REEZA GUILLERMO-ESQUILLO, RMT, MLS (ASCPi) phlebotomy needles, broken contaminated biological agents, such as viruses and glass, and pipettes bacteria. 2. Eye wash stations C.Physical hazards must be inspected and tested periodically for Physical hazards include exposure to noise, proper function. poor posture and the explosibility and flammability of substances. 3.Safety showers provide an effective means of treatment in D.Safety hazards the event that chemicals are spilled or Safety hazards include unbalanced splashed onto the skin or clothing. They centrifuges, danger when handling hot must be inspected and tested periodically for sterilized items and electrical hazards, such proper function. as shock, explosions, blasts and electrocutions. 4.Refrigerators Each refrigerator and freezer must be E.Allergy hazards monitored daily to ensure proper functioning. A common allergy hazard in the laboratory setting is a latex allergy, as many of the 5.Alarms materials used in a laboratory setting are are designed so that endangered personnel latex. are alerted. All individuals should become familiar with the exact location of the fire Dangers in the laboratory setting can alarm stations nearest to their laboratory. also come from unsafe practices, including: 6. Chemical spill kits 1. Working alone in the laboratory a. Laboratories are equipped with clean-up 2. Neglecting to wear a lab coat kits for various types of spills. 3. Lack of safety training b. Wear the appropriate PPE (i.e., gloves, XII.RISK OF INFECTION: WHAT goggles) when cleaning up spills. HEALTHCARE PERSONNEL NEED TO KNOW XI. THE DANGERS OF WORKING IN A LABORATORY SETTING A. Risk of infection depends on The dangers of working in a laboratory The pathogen involved setting include: Type of exposure Amount of blood involved A.Chemical hazards: Amount of virus in the exposed blood Handling toxic substances can cause B. If exposed to blood immediately irritation and carcinogenicity. Wash with soap and water Flush splashes to nose, mouth or skin B. Biological hazards with water Biological hazards include hazards from Irrigate eyes with clean water, saline or working with small animals, working with sterile irrigants bloodborne pathogens and working with PRELIMS | 1ST SEMESTER A.Y. 2024 - 2025 Page 4 of 9 farahway˙✧˖°🪸 ༘ ⋆｡˚ MOLECULAR BIOLOGY RMT2026 INSTRUCTOR: NIÑA REEZA GUILLERMO-ESQUILLO, RMT, MLS (ASCPi) C. What is the risk after an exposure if: Vaccinated against Hepa B = no risk Unvaccinated = risk factor of 6-30% Exposure to Hepa C = risk is 1.8% B.Disinfecting Procedure HIV needlestick /cut exposure = 0.3% While wearing gloves, employees HIV exposure to eyes, nose or mouth should clean and sanitize all work = 0.1% surfaces at the beginning and end of HIV exposure to non-intact skin = their shift with a 1:10 dilution of 0.1% household bleach. HIV exposure to intact skin = no risk Instruments should be sanitized daily D. Treatment with a diluted solution of bleach. An area contaminated by either blood HBV : all healthcare workers should receive vaccination or body fluids needs to be treated as potentially hazardous, with prompt HCV : no vaccine available and no removal and surface disinfection. treatment to prevent infection Strategies differ for decontaminating HIV: Antiretroviral drugs are available if spills of blood and other body fluids; appropriate. the cleanup procedure depends on Post exposure treatment (if the setting (e.g., porosity of the appropriate) should begin within 24 surface) and volume of the spill. hours and no later than 7 days. C.The following protocol is XIII. DECONTAMINATION OF WORK recommended for managing spills in a SURFACES, EQUIPMENT AND SPILLS clinical laboratory: A. Disinfecting Solutions 1. Wear gloves and a laboratory coat. Hypochlorites are the most widely used of the chlorine disinfectants. 2. Absorb the blood with disposable The most prevalent chlorine products towels. Remove as much liquid blood in the United States are aqueous or serum as possible before solutions of 5.25% to 6.15% sodium decontamination. hypochlorite, usually called household bleach. 3. Using a diluted bleach (1:10) solution, Bleach, a broad spectrum of clean the spill site of all visible blood. antimicrobial activity, does not leave a toxic residue and is unaffected by 4. Wipe down the spill site with paper water hardness. towels soaked with diluted bleach. \ In addition, bleach is inexpensive and fast acting, removes dried or fixed microorganisms from surfaces, and 5. Place all disposable materials used has a low incidence of serious for decontamination into a biohazard toxicity. container. PRELIMS | 1ST SEMESTER A.Y. 2024 - 2025 Page 5 of 9 farahway˙✧˖°🪸 ༘ ⋆｡˚ MOLECULAR BIOLOGY RMT2026 INSTRUCTOR: NIÑA REEZA GUILLERMO-ESQUILLO, RMT, MLS (ASCPi) 6. Decontaminate non disposable material by mouth is strictly forbidden equipment by soaking overnight in a. dilute bleach (1:10) solution and rinsing with methyl alcohol and water 6. No tobacco products can be used in before reuse. Disposable glassware the laboratory. or supplies that have come in contact with the blood should be autoclaved 7. No manipulation of contact lenses or or incinerated. teeth-whitening strips should be done with gloved or potentially infectious hands. XIII. GENERAL INFECTION CONTROL SAFETY PRACTICES 8. Do not apply lipstick or makeup. A variety of other safety practices should be adhered to, to reduce the risk of 9. All personnel should be familiar with inadvertent contamination with blood or the location and use of eyewash certain body fluids. stations and safety showers. These practices include the following: XIV.SPECIMEN-PROCESSING PROTECTION 1. All devices in contact with blood that Protective gloves should always be are capable of transmitting infection worn for handling any type of to the donor or recipient must be biological specimen. Biohazards are sterile and nonreusable. generally treated with great respect in the clinical laboratory. The adverse 2. Food and drinks should not be effects of pathogenic substances on consumed in work areas or stored in the body are well documented. the same area as specimens. The presence of pathogenic Containers, refrigerators, or freezers organisms is not limited to the culture used for specimens should be plates in the microbiology laboratory. marked as containing a biohazard. Airborne infectious particles, or aerosols, can be found in all areas of 3. Specimens needing centrifugation the laboratory where human should be capped and placed into a specimens are used. centrifuge with a sealed dome. Another step that should be taken to control the hazard from aerosols is to 4. Rubber-stoppered test tubes are exercise caution in handling pipettes opened slowly and carefully with a and other equipment used to transfer gauze square over the stopper to human specimens, especially minimize aerosol production (the pathogenic materials. These introduction of substances into the materials should be discarded air). properly and carefully. XV. SPECIMEN-HANDLING AND 5. Autodilutors or safety bulbs are used SHIPPING REQUIREMENTS for pipetting. Pipetting of any clinical PRELIMS | 1ST SEMESTER A.Y. 2024 - 2025 Page 6 of 9 farahway˙✧˖°🪸 ༘ ⋆｡˚ MOLECULAR BIOLOGY RMT2026 INSTRUCTOR: NIÑA REEZA GUILLERMO-ESQUILLO, RMT, MLS (ASCPi) The proper handling of blood and A laboratory determination is best body fluids is critical to the accuracy done on a fresh specimen. of laboratory test results, and the safety of all individuals who come in XVII. OSHA Medical Waste Standards contact with specimens must be OSHA standards provide for the guaranteed. implementation of a waste disposal program If a blood specimen is to be transported, the shipping container OSHA Regulation of Medical Waste must meet OSHA requirements for Contaminated reusable sharps must shipping clinical specimens. be placed in containers that are Shipping containers must meet the puncture resistant; labeled or color packaging requirements of major coded; and leak-proof on the sides couriers and Department of and bottom. Transportation hazardous materials Reusable sharps that are regulations. contaminated with blood or other Approved re-closable plastic bags for potentially infectious materials must handling biohazardous specimens not be stored or processed in a and amber bags for specimens for manner that requires employees to analysis of light-sensitive drugs are reach by hand into the containers. available. Specimens of blood or other Approved bags have bright orange potentially infectious material are and black graphics that clearly required to be placed in a container identify bags as holding hazardous that is labeled or color coded and materials closed prior to being stored, transported, or shipped. XVI. Storage of Processed Specimens Contaminated sharps must be placed Some specimens must be analyzed in containers that are closeable, immediately after they reach the puncture resistant, leakproof on sides laboratory. and bottoms, and labeled or color Blood specimens for hematology coded. studies can be stored in the Regulated wastes (liquid or refrigerator for 2 hours before being semiliquid blood or other potentially used in testing. infectious materials; After storage, anticoagulated blood contaminated items that would must be thoroughly mixed after it has release blood or other potentially reached room temperature. infectious materials in a liquid or Plasma and serum often can be semiliquid state if compressed; items frozen and preserved satisfactorily that are caked with dried blood or until a determination can be done. other potentially infectious materials Whole blood cannot be frozen and are capable of releasing these because RBCs rupture on freezing. materials during handling; Freezing preserves heat-sensitive contaminated sharps; coagulation factors. and pathological and microbiological wastes containing blood or other PRELIMS | 1ST SEMESTER A.Y. 2024 - 2025 Page 7 of 9 farahway˙✧˖°🪸 ༘ ⋆｡˚ MOLECULAR BIOLOGY RMT2026 INSTRUCTOR: NIÑA REEZA GUILLERMO-ESQUILLO, RMT, MLS (ASCPi) potentially infectious materials) must Analytical variables be placed in containers that are occur during actual testing of the closeable, constructed to contain all specimen. Performance of tests in the contents and prevent leakage of laboratory is rigorously controlled, fluids, labeled or color coded, and with quality control procedures in closed prior to removal place that markedly reduce errors in All bins, pails, cans, and similar the analytic phase of testing. receptacles intended for reuse, which Differences in the methods for have the likelihood of becoming performing tests in different contaminated with blood or other laboratories may yield slight potentially infectious materials, are differences in reported results or required to be inspected and normal ranges, so check reference decontaminated on a regularly ranges given for the test. scheduled basis. Waste containers must be easily Postanalytical variables occur accessible to personnel and must be after a test result is generated. In located in the laboratory areas where general, such postanalytical errors they are typically used. Containers for occur with entry, manipulation, and waste should be constructed so that reporting of test data. If results are their contents will not be spilled if the written by hand or entered via container is tipped over accidentally. keyboard, then an entry error may Labels affixed to containers of occur. regulated waste; refrigerators and Errors in data transmission include freezers containing blood or other relaying or hearing verbal information potentially infectious materials; and incorrectly. Reporting problems other containers used to store, include exceeding the turnaround transport, or ship blood or other time for reporting or not notifying the potentially infectious materials must appropriate health care provider. include the biohazard symbol; be fluorescent orange or orange-red or Examples of Potential Preanalytical predominantly so, with lettering and /Analytical/ Postanalytical Errors symbols in contrasting color; and be affixed as closely as possible to the PREANALYTICAL container by adhesive or wire to 1. Specimen obtained from the wrong prevent loss or removal. Source: patient www.fedcenter.gov 2. Specimen procured at the wrong time 3. Specimen collected in the wrong tube XVIII. PREANALYTICAL, ANALYTICAL or container AND POSTANALYTICAL VARIABLES 4. Blood specimens collected in the wrong order Incorrect labeling of Preanalytical variables specimen occur prior to specimen testing and 5. Improper processing of specimen may include variables involving the process of obtaining a specimen. ANALYTICAL (EXAMINATION) 1. Oversight of instrument flags PRELIMS | 1ST SEMESTER A.Y. 2024 - 2025 Page 8 of 9 farahway˙✧˖°🪸 ༘ ⋆｡˚ MOLECULAR BIOLOGY RMT2026 INSTRUCTOR: NIÑA REEZA GUILLERMO-ESQUILLO, RMT, MLS (ASCPi) 2. Out-of-control QC results 3. Wrong assay performed POSTANALYTICAL 1. Verbal reporting of results 2. Instrument: Laboratory Information System (LIS) incompatibility error 3. Confusion about reference ranges 4. Failure to report critical values immediately PRELIMS | 1ST SEMESTER A.Y. 2024 - 2025 Page 9 of 9 farahway˙✧˖°🪸 ༘ ⋆｡˚